By BILL LUNDQUIST
GOLD BEACH Cal-Ore Life Flight's ambulance franchise was renewed Monday for another five years.
First, however, the company and the Curry County commissioners had to reach a gentlemen's agreement on some key issues.
The commissioners also renewed the ambulance service area No. 1 franchise held by Port Orford Ambulance.
No other applications were submitted for the franchise.
The commissioners deemed discussion unnecessary because the application raised no issues outside of the standard franchise agreement.
The application from Cal-Ore for the ambulance service area franchise for the rest of Curry County, however, raised several issues.
Company manager Dan Brattain attended the meeting to answer the commissioners' questions.
Not one member of the public attended the hearing. Brattain said the lack of complaints was a good indication of the satisfaction of Curry citizens with Cal-Ore.
Brattain was also not surprised that no other companies applied for a franchise in Curry County.
He said recent cuts in Medicare reimbursements make it hard for ambulance companies to survive in a county with the low call volume and location of Curry.
Brattain made it clear to the commissioners that Cal-Ore could not survive if it had to pay a franchise fee to Curry County.
He said Del Norte County pays Cal-Ore a subsidy to transport indigents. Brattain didn't ask for the same arrangement from Curry County, but said the commissioners had never charged a franchise fee, and he hoped that would continue.
Commissioner Lucie La Bont said the commissioners may have to rethink that policy if they have to take out loans to replace the county's crumbling emergency communications towers and antiquated equipment.
"The county is paying the full freight on the replacement of emergency towers," said La Bont. She asked if Cal-Ore could charge its customers more to cover a franchise fee.
Brattain said Cal-Ore could raise its rates, but that wouldn't necessarily produce more income.
He said 65 percent of the clients Cal-Ore transports are covered by Medicare, and 12-13 percent by the Oregon Health Plan. Both pay only a set amount.
He said providers in the Eastern United States received an increase in Medicare reimbursement rates, while the Western states suffered a decrease.
County Counsel Jerry Herbage said state statutes do allow the commissioners to adopt franchise fees to cover administrative costs.
Commissioner Rachelle Schaaf said renewing the franchise had taken a considerable amount of the county counsel's time.
Herbage said preparing the request for proposals and advertising, plus attending several meetings, had taken some time.
Brattain said they could keep discussing the issue, but he wanted to make one thing clear: "I'm not going to accept the franchise with franchise fees."
"It may be bad timing," said La Bont. "I would rather leave it the way it is now."
Commissioner Marlyn Schafer agreed, but asked if Brattain was requesting that the commissioners change the county ordinance so they could never charge a franchise fee.
Brattain said he was only requesting that Cal-Ore not be charged. The commissioners agreed to that request, for now.
Brattain said the second issue was that companies were coming into other counties to provide non-emergency transport in "stretcher cars."
He requested that the franchise agreement give Cal-Ore the exclusive right to transport clients within the service area who need to be moved on a stretcher or gurney.
He said his request didn't apply to wheelchair vans that transport people to doctors.
"We need every single call we can get to make this work," said Brattain.
La Bont said the commissioners could agree to Brattain's request, but would have to word the agreement carefully.
Brattain said the state-mandated merger of the county's two Public Safety Answering Point, or 9-1-1, centers could also affect the franchise.
He said Cal-Ore is presently paying the Brookings 9-1-1 center $1,000 a month for dispatching, and is discounting its charges to the county to help pay for the Central County center.
"We will gladly pay $1,000 a month to the new 9-1-1 center," he said, "but we can't pay $2,000 to $5,000 a month."
La Bont said the commissioners didn't yet know what the costs for the new combined 9-1-1 center would be.
She suggested they write into the agreement that Cal-Ore would be charged a reasonable amount.
Brattain's final request was that the commissioners agree to grant Cal-Ore a three-year extension of its franchise, if it is performing at a level to be determined by the commissioners.
He said he will be replacing ambulances when there is about a year left on the new franchise agreement, which may make it difficult to obtain loans.
Herbage said the request for proposals were issued for a five-year franchise agreement. He said others may have applied if they'd known it was for eight years.
Brattain said he wasn't demanding that be a condition of the agreement. "I just want to brief you on my thoughts," he said.
"We plan to be here a long time. I hope the commissioners are open to an extension in three years. I'm not asking to accomplish that today."
"We looked at a lot of counties," said Brattain. "We have a really unique situation here in Curry County."
He said the largest part of the population is 26 miles from the nearest hospital. Because of that, he said, once a transport team is called out, it takes about two hours before it is back in district.
Brattain said Cal-Ore scrambled to respond to seven calls in four hours Saturday, then had no more calls the rest of the day.
"It takes a lot of labor," he said. "We average two and a half calls a day per ambulance. In Portland, that would be 12 to 15."
He said when Cal-Ore took over the failing operation in Curry County, other ambulance services didn't think the company could make it work.
He said the key to success was combining air and ground transport. He said while Medicare lowered reimbursement rates for ground transport, it actually raised them for air.
The commissioners approved the franchise agreement with most of Brattain's requests.
They also instructed Herbage to develop a process for granting a franchise extension in the future.
La Bont thanked Cal-Ore for saving the ambulance service.
"It was such a mess," she said. "It was magic to take over and do what you did."
Brattain credited that to the skills of his employees.